| NPI | 1831280171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: DE C10005644) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: DE C10005644) |
| 208000000X Pediatrics (Licence: DE C10005644) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DE C10005644) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2011-09-10 |